I am booked in for surgery in a few weeks. My scans showed that the styloid processes were elongated and that the right side was larger than the left (all my symptoms are on the right side). It also showed calcific ligaments bilaterally. To minimise risks of nerve damage, my ENT surgeon has decided to take a slightly more conservative approach of dividing the ligament and attempting to remove the entire ligament up to the styloid process. I asked him if in the future the actual process woul dneed to be removed if this would still be possible. He said yes in theory but dealing with the scarring that will be left from this surgery might get a bit complex.
Has anyone had this surgical approach performed on them? If so did they get any relief from symptoms?
Mark, I just wanted to give you my thoughts. I am by no means an expert - I've been dealing with Eagles for about 4 years now and have had 4 surgeries, but I don't know as much as some of the people on here.
However, this doesn't sound all that great to me. And I've never heard of this approach before either. We definitely have pain from BOTH calcified styloids as well as the calcified ligaments. BUT, it's probably MORE likely that your pain is from the syloid than the ligament. I think both have to come out. If I had to choose one, I'd choose the styloid, but I think it should be both.
It sounds like he might not want to go back in later because of scar tissue, but then you'd be stuck with the styloid that is most likely the cause of most of your pain.
Is there any way you can go to another doctor? I know the choice of doctors with knowledge about Eagles is very limited, but I think this surgery may be setting you up for a lot of pain and frustration in the future.
Thanks for your advice. I'm in Australia and the choice of surgeons that are willing to perform surgery for Eagle's is very limited. Did you get complete relief after your 4 surgeries? Do you have any lasting effects from the surgeries themselves such as pain, dysfunction etc.
I have had much relief from surgery (left on 11/25 and right on 3/10 . It is hard to find ES surgeon but Best advice is to find one that has performed the surgery often.
I've had relief from most of my Eagles' symptoms, but I have really bad nerve pain still. It is apparently coming from a piece of the styloid that the revision surgery couldn't get to because of scar tissue. So now it appears that I suffer for the rest of my life with pain that I'm not sure I can deal with.
Hi Aussie… I am two months post op. I’m also in Australia, however I am in NSW. from what I nderstand, you can have just have calcified stylohyoid ligaments and they can be operated on by themselves…BUT…you said that your scans showed that you also have elongated styloid process bilaterally. I had both the styloid elongation and the calcified ligament…I have only had one side done so far but my surgeon spoke to me about how he did both. He split the ligaments and these need to remain ans they are an important part of the anatomy and perform necessary function. Te styloid process however, when elongated is not something that needs to remain…if at all. I had mine shortened but would have been happier with the whole thing removed I think. In saying that, there is more fish apparently to the facial nerve with full removal. I have had a wonderful surgeon and he made a great deal of difference to my left side although I am still definitively in recovery mode. Again…that being said, I don’t know if I can blame the eagles entirely for my slow recovery…I have recently had a MRI as many things were taking too long and also had new symptoms emerging…I thought that maybe it was the right side affecting the vagus nerve etc etc and asked for a ct (ct’s show the bone rather than soft tissues as the MRI does)…anyway, it turns out that I have a large cyst pushing on my cerebellum and have a compression occurring in the medulla oblongata. My surgeon is very clever as when I questioned why an MRI instead…he said trust me…we need to look at the brain. He was right. My doctor is a ENT Head and Neck surgeon and I cannot speak highly enough of him. I think he has taken good care of the eagles on the left side even though I didn’t think so initially. I have to have the right side done but he said I need to hold off until we get this other stuff sorted. I saw the neurosurgeon last week and another MRI has been scheduled for next Thursday to get a clearer picture of the problems and it looks like brain surgery after that. If you want to talk to me about anything…message me and send me your number and I will call you. I know how thought consuming this can all be prior to surgery as do all the amazing people on here I am sure. They certainly provided me with a ton of help. BTW…I THINK YOU NEED A SECOND OPINION…I forgot to mention that…
Mark, I keep thinking about your surgery. I think if you have this done, you will continue to have bad pain, and then it's very likely the doctor won't want to do another surgery. If you go to other doctors then to do another surgery, you very well might run into resistance because they won't want to operate where another doctor has operated before.
A number of people have said this before a number of times, but to get the best outcome over the years, the best option is to get the whole styloid removed the first time you have the surgery done, and the best way to do that is with an external operation. And the best way to get that done is by a doctor who has had experience with Eagles surgeries before. If not, you really run the risk of having problems down the road and having a real hard time finding a doctor to redo the surgery.
Well just an update to my situation. I agreed to go ahead with the external removal of the right stylohyoid ligament. I would not suggest this to anyone. It did not help my symptoms and now 3.5 months out of surgery I still have a very weak feeling on that side when I swallow. I didn't have this before surgery. Also it feels like there is a constant lump in my throat. The ENT that did my surgery is not sure why this would be. He said that hyoid surgery is not uncommon and it usually does not result in any problems. He took off the small horn of the hyoid and as much of the ligament as he could get. I have quite a bit of weakness in the muscle around the scar and the platysma bunches up under my chin when I tense it. I have no nerve damage that I can tell. Had a little numbness under my chin for the first couple of weeks but that seems to have settled. Due to the scarring, the surgeon said he will not attempt an external styloidectomy. He will consider doing an internal approach to shorten it if I really want him to. At this stage I just want my swallow back and am unsure on how to go about this. Maybe shortening the styloid may help?Thanks for all of the advice. It is very hard to find anyone in Australia that is willing to do surgery for this condition. I went to 5 ENTs before I found someone willing to and could only really trust them in their approach.
So sorry about the symptoms you are having from your external surgery. I just recently joined this site and read your post from March. I know you already had your surgery but I figured it wouldn’t hurt to reply anyway. I was going to say that I would be on the search for an Oral surgeon. I seen 2 ENTs who both gave me different “opinions” before I seen the Oral Surgeon. He knew exactly what it was after I had the CAT scan done. Internal Styloidectomy was the Best approach. By doing external there are many more risks. I had my surgery on 6-13-14 and really an only experiencing a bit tingling in my tounge still, tenderness in left cheek & neck and mouth limitations (can only open about an inch). I really hope that you get some relief from this “lump” in your throat. I dont know how long you have dealed with this but I know that it’s probably really discouraging. Took me 6 years to get answers.
aussie77 said:
Well just an update to my situation. I agreed to go ahead with the external removal of the right stylohyoid ligament. I would not suggest this to anyone. It did not help my symptoms and now 3.5 months out of surgery I still have a very weak feeling on that side when I swallow. I didn't have this before surgery. Also it feels like there is a constant lump in my throat. The ENT that did my surgery is not sure why this would be. He said that hyoid surgery is not uncommon and it usually does not result in any problems. He took off the small horn of the hyoid and as much of the ligament as he could get. I have quite a bit of weakness in the muscle around the scar and the platysma bunches up under my chin when I tense it. I have no nerve damage that I can tell. Had a little numbness under my chin for the first couple of weeks but that seems to have settled. Due to the scarring, the surgeon said he will not attempt an external styloidectomy. He will consider doing an internal approach to shorten it if I really want him to. At this stage I just want my swallow back and am unsure on how to go about this. Maybe shortening the styloid may help?Thanks for all of the advice. It is very hard to find anyone in Australia that is willing to do surgery for this condition. I went to 5 ENTs before I found someone willing to and could only really trust them in their approach.
